动力髋螺钉和股骨近端髓内钉治疗股骨转子间骨折的疗效比较

Comparison of dynamic hip screws and proximal femoral nails in the treatment of intertrochanteric fracture of femur

目的探讨股骨转子间骨折两种内固定手术方式的疗效.方法随机选取84例股骨转子间骨折患者,给予动力髋部螺钉(DHS)内固定术48例和股骨近端髓内钉(PFN)内固定术36例,记录两组术中、术后的相关指标并给予统计分析.结果所有患者均随访12～32个月,骨折全部愈合,无死亡病例.两组相比,手术时间、切口长度、术中出血量和术后近期并发症以及术后髋关节功能优良率的差异均有显著性(P<0.05).结论与DHS相比,PFN具有固定牢靠、手术创伤小、并发症少的优点,尤其适用于A2.3和A3等不稳定性股骨转子间骨折.

Objective To investigate the effect of 2 internal fixation procedures for intertrochanteric fracture of femur. Methods 84 cases of intertrochanteric fractures of femur were divided into two groups and were treated with dynamic hip screws （DHS） and proximal femoral nails （PFN）, respectively. Multiple indexes were recorded intraand post-operatively, and analyzed statistically. Results All cases were followed up for 12 -32 months. All got healing and no cases died. The difference of operation time, incision length, intra-operative blood loss, and postoperative short-term complication and hip function between the two groups was significant （ P 〈0. 05 ）. Conclusions Compared with DHS, PFN has advantages of more rigid fixation, fewer trauma and fewer complications, especially for A2. 3 and A3 unstable intertrochanteric fracture of femur.